Please enable JavaScript.

Coggle requires JavaScript to display documents.

Eating Disorders - Coggle Diagram

- - - - Cardiovascular
        
        ↓ BP
        
        ↓ HR
        
        Cardiomyopathy
      - Electrolyte / Endocrine
        
        ↓ K+
        
        ↓ Glucose
        
        Amenorrhoea
      - Neuromuscular
        
        ↓ Muscle mass
        
        Proximal myopathy
        
        Peripheral neuropathy
      - Haematological
        
        ↓ Hb - Anaemia
        
        ↓ WCC
        
        ↓ Platelets
      - Dermatological
        
        Lanugo body hair
      - Bone
        
        Osteopaenia
        
        Osteoporosis
      - Fertility
        
        Reduced - HPA dysfunction
    - - ↓ Concentration
      - ↓ Memory
      - ↓ Energy
      - Social Withdrawal
      - Depression
      - Increased risk of suicide
      - Anxiety
      - Obsessive-compulsive behaviours (rituals associated with eating)
  - - - Recent weight loss
      - Genetics
      - HPA dysfunction - may be secondary to prolonged starvation
    - - Family theories - enmeshment , over protectiveness
      - Psychodynamic theories - fixation on oral satge
      - Personality and temperament
      - Socio-cultural influences - Westernization, media, social pressure
  - - - Education and psychological support
      - Family therapy in U18
      - CBT-E
      - SSCM - Specialist supportive clinical management
      - MANTRA - Maudsley model of anorexia nervosa treatment for adults
    - - Medical Re-feeding
      - MARSIPAN guidelines
      - Key points
        
        Consistent weighing procedures
        
        Fluid and intake charts
        
        Gradual re-feeding
        
        Monitoring weight gain
    - - Indications
        
        Severe rapid weight loss (>1kg/week)
        
        BMI <14
        
        Electrolyte disturbances
        
        Deterioration in physical complications ( ↓ BP / HR)
      - Components
        
        Medical re-feeding
        
        Psychological care
        
        Psychotropic medication (rare)
      - Physical Assessment
        
        Sit-up / squat tests
        
        Bloods
        Glucose
        Phosphate
        Mg
        LTFs
        FBC
        
        ECG
        (QTc , ST/T wave)
  - - - Confusion
      - Coma
      - Seizures
- - - - Electrolytes
        
        ↓ K+
        
        ↓ Na+
        
        ↓ Cl-
      - GI
        
        Dental errosions
        
        Parotid swelling
        
        Oesophageal erosions
        
        Oesophageal rupture
        
        Gastric ulcers
        
        Pancreatitis
      - Cardiovascular
        
        Arrythmias
        
        Cardiac failure
      - Haematological
        
        ↓ WCC
      - Dermatological
        
        Russell's pads
        ( on fingers from putting fingers into mouth to induce vomiting
    - - Depression
      - Anxiety
      - Low self esteem
      - Impulsive self harm
      - Impulse control disorders including substance / alcohol
  - - - CBT
    - - SSRIs - fluoxetine may reduce frequency of binge/ purge
    - - Rarely for physical
        May be needed for severe depressive ep / self harm